Browsing by Author "Ndyamukama, Aika"

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    Access to healthcare for people with physical disability in Tanzania: a case of Singida rural district, Singida-Tanzania
    (NM-AIST, 2022-08) Ndyamukama, Aika
    This cross-sectional study explored the availability and affordability of healthcare services for people with a physical disability (PWPDs). Also, it determined whether the existing infrastructure at health facilities in Singida rural district supports PWPDs. The study applied mixed-method approaches involving quantitative and qualitative surveys with 15 key informants and 90 participants PWPDs from 18 wards and all 32 health facilities found in the district. To avoid the chance of the respondent‟s response being influenced by their parents and to make the respondents feel free to talk about whatever is in their mind about access to healthcare for PWPDs, the researcher selected 5 respondents in each ward aged 18 and above who could express themselves without being represented. The study used simple random, purposive, and snowballing sampling techniques to yield 90 respondents, 15 key informants, and 32 health facilities. Participants with physical disabilities were determined using the Washington Group on Disability statistics questions set to provide basic information on disability comparable worldwide. Data were collected using a questionnaire survey, interview, and observation. The researcher employed SPSS-26 software to analyze quantitative data and NVivo-12 software to analyze qualitative data. The analysis was conducted to obtain frequencies and percentages. Data presented in figures and tables; A thematic analysis was applied to determine certain variables such as age, gender, infrastructure, and access to healthcare services. The Chi-square test was employed to test the relationship between categorical variables. The study found that in Singida rural district, there were no special health facilities and specialist nurses/ doctors for PWPDs. Most of them still experience delays in getting an appointment and other services from nurses, primary care doctors, specialists, treatment interventions, and medical equipment. Similarly, the available healthcare service is not affordable to PWPDs, and most of them were not beneficiaries of health insurance schemes hence depending on the out-of-pocket payment system. Furthermore, the infrastructures at health facilities do not favor PWPDs. Therefore, the findings indicate that access to healthcare for PWPDs in Singida rural district is not available and affordable for PWPDs. Also, the existing infrastructure at health facilities doesn't support PWPDs to access healthcare. The study suggests that the government and other healthcare stakeholders should consider access to healthcare for PWPDs in rural areas where most PWPDs are at risk.
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    Access to Supportive Health Services for People with Physical Disabilities: A Case of Health Facilities in Singida Rural District, Tanzania
    (Scientific Research Publishing Inc., 2022-03-30) Ndyamukama, Aika; Dillip, Angel; Chipwaza, Beatrice
    Background: It is estimated that above one billion people (15%) of the world’s populations are living with disabilities. The poor and unfriendly infrastructure at health facilities is the core challenge for people with physical disabilities in accessing healthcare. This study aimed to explore at what extent the existing infrastructure and design of health facilities in Singida rural district, Tanzania supports people with physical disabilities to access healthcare. Methods: A cross sectional health facility-based assessment of all thirty-two functioning health facilities in the district was done between June and December 2020 using observational checklist and key informants’ interviews consist of measurement procedures of the architectural condition of health facilities. Observation checklist was designed based on standard of health facilities in Tanzania, national guideline for safe care standards for dispensaries, health centers and district hospital of 2014 and national guideline for water, sanitation and hygiene in healthcare facilities of 2017. Data were analyzed by SPSS-26 using descriptive statistics to obtain frequencies tables, percentage and figure. Qualitative data were analyzed by using NVivo-12 software. Results: The study revealed that there was no signage, entrance area, parking and toilets designated for people with physical disabilities in all health facilities. There was no special seat, examination table/bed and special weight scale for people with physical disabilities in all facilities. Also, the doors were not wide enough to support wheelchair user to maneuver in all health centers and dispensaries. In addition, door handles were not user friendly for wheelchair users. In fact, only the hospital and health centers had wheelchairs while 27 (96.4%) of all dispensaries had no wheelchairs. Furthermore, ramp and pathways were not available in all dispensaries. All health facilities had stairs but the challenge was most of the staircases had no floor located before the steps. Conclusion: The study revealed that the infrastructures in most healthcare facilities pose challenges to people with physical disabilities when they access healthcare services. These findings call for need of improving health facilities’ infrastructure to accommodate people with physical disabilities and this should be given a priority.